Health Coverage History of Local Uninsured Patients: Assessing the Need for an Eligibility Specialist

Uninsured Americans are a growing population as insurance premiums climb and fewer employers offer health coverage. Providing medical care to the uninsured often represents a significant financial loss to medical institutions. Our study sought to describe the insurance history and barriers to obtaining health coverage for uninsured patients at the Community Health Center of Burlington, Vermont (CHCB). Data were collected by random phone survey from 100 CHCB patients identified as uninsured at their last visit; patients were queried regarding insurance history and interest in enrollment assistance. At the time of survey, 66% were currently uninsured, and the majority (87.9%) of these respondents previously held insurance, raising the possibility that health insurance options existed for some of these individuals. Loss of insurance was most often due to a change in job status, income or a change in eligibility, factors potentially influencing eligibility for public programs. Cost was a major barrier to insurance noted by individuals; however, respondents indicated they would be willing to pay a premium of around $65 per month for coverage. A majority (75.7%) of uninsured respondents also expressed interest in an onsite eligibility worker to help them navigate health insurance options or gain insurance coverage from available state programs. These data suggest that the patient population at CHCB would be well served by implementing some form of eligibility staffing or systematic assessment of eligibility. There are a variety of different health insurance programs in Vermont that could benefit these patients, provided they have assistance with applying.